The interplay between gut microbiota and retinal health, known as the gut-–retina axis, has gained increasing attention in recent years. Short-chain fatty acids (SCFAs), metabolites produced by gut microbiota, have been identified as key mediators of gut–retina communication. This systematic review explores the role of SCFAs in retinal health and their potential impact on the development and progression of retinal diseases, such as diabetic retinopathy (DR), age-related macular degeneration (AMD), and glaucoma. A literature search was conducted across multiple databases, including PubMed, Google Scholar, and Science Direct, to identify studies published between 2014 and December 2024. Studies were included if they investigated the effects of SCFAs on retinal structure, function, or disease pathogenesis in animal models or human subjects. The review included 10 original articles spanning both preclinical and clinical studies. Evidence suggests that SCFAs play a crucial role in maintaining retinal homeostasis through anti-inflammatory and neuroprotective mechanisms. Dysbiosis of the gut microbiota, leading to altered SCFA production, was associated with increased retinal inflammation, oxidative stress, and vascular dysfunction. Furthermore, reduced SCFA levels were linked to the progression of retinal diseases, such as diabetic retinopathy and age-related macular degeneration. Modulation of gut microbiota and SCFA levels through dietary interventions or probiotics may represent a novel therapeutic strategy for preventing or managing retinal diseases. Further research is needed to elucidate the precise molecular mechanisms underlying SCFA-mediated retinal protection and to evaluate the efficacy of targeted therapies in clinical settings.
Pollen–food allergy syndrome (PFAS), also known as oral allergy syndrome, is a common condition affecting individuals sensitized to pollens such as birch, ragweed, and grass. This syndrome arises from immunological cross-reactivity between pollen allergens and structurally similar proteins found in various fruits, vegetables, and nuts. Although typically presenting with mild oral and pharyngeal symptoms, PFAS can occasionally result in severe allergic reactions, underscoring its clinical significance. This review explores the pathophysiology of PFAS, highlighting the molecular mechanisms underlying cross-reactivity and examining the main protein families involved, including those contributing to variations in symptom severity. Current diagnostic approaches, including skin prick testing, specific immunoglobulin E measurements, and component-resolved diagnostics, are discussed. Emerging diagnostic tools and biomarkers with potential to enhance accuracy are also examined. Therapeutic strategies for PFAS primarily focus on symptom management and avoidance of trigger foods. However, novel approaches such as allergen immunotherapy and biologics targeting key immune pathways are gaining traction as potential interventions for more severe or refractory cases. By addressing the diagnostic and therapeutic challenges of PFAS, this paper aims to provide clinicians and researchers with a comprehensive understanding of this condition, fostering improved patient care and the development of innovative treatment strategies.
Leptospirosis is a zoonotic disease with a varied clinical presentation that can mimic other infectious diseases, posing diagnostic challenges. While the Microscopic Agglutination Test (MAT) remains the gold standard for serological diagnosis, its limitations have led to increasing interest in polymerase chain reaction (PCR) as a rapid and sensitive diagnostic tool. This systematic review evaluates the role and clinical applications of PCR for diagnosing human leptospirosis. We analyzed the sensitivity and specificity of PCR, compared its performance with other diagnostic tests, and assessed the comparative utility of blood and urine samples for PCR testing. Our findings demonstrate that PCR has a high sensitivity and specificity, particularly in the early stages of the disease. Combining PCR with serological tests like MAT can maximize the diagnostic accuracy across different stages of illness. We recommend that PCR be considered a first-line diagnostic test for suspected leptospirosis, especially when rapid diagnosis is crucial. Further research is needed to standardize PCR protocols and explore its potential in differentiating Leptospira species and serotypes. By leveraging the strengths of PCR and combining it with other diagnostic methods, we can significantly improve the diagnosis and management of leptospirosis.
The management of the COVID-19 pandemic in Romania has included the involvement of not only the medical system, but also that of the administrative and social services. All these organizations are working together to lower the impact on the health of the general population, to increase the health system’s response capabilities and even to diminish the negative effects upon the economy due to the epidemic’s length. Therefore, non-pharmacological measures (NPMs) imposed through restrictive measures (administrative, economic and individual) have influenced the evolution of morbidity and mortality. Even from the first months of the pandemic’s progression, researchers have shown the impact of the NPMs’ existence, as there were many studies on all NPMs in conjunction, as well as those targeting specific measures such as school closures. Our study started by establishing a temporal relationship between the non-pharmacological measures found in most countries (wearing a mask, washing hands and physical distancing, limiting economic activities, closing schools, limiting internal and international movement, banning public and private events in closed spaces) and the evolution of the pandemic in Romania. The degree of novelty brought by this study consists of extending the analysis to the pre-existing state of the health system and to the measures meant to increase the resilience of the population, as well as to the measures aimed at reducing the type of risk, and factors that can equally influence the evolution of the number of cases. The results of the statistical analysis show the important effects of certain NPMs (mask mandates, online schooling, decisions regarding imposing or lifting local restrictions) as well as the reduced impact of other measures (hand disinfection, social distancing or the restriction of public and private events). Hence, it can be concluded that during such pandemics, implementing quick, simple measures can prevent the spread of the disease and help fight the contagion in a better manner.
Allergen immunotherapy (AIT) is a well-established treatment aimed at reducing allergen sensitivity by gradually exposing the immune system to increasing doses of allergens. This promotes desensitization and immune tolerance through multiple mechanisms. AIT offers long-term immune modulation and is considered a potentially curative certain forms of allergic diseases. Altered antibody responses is a key mechanism of AIT in the production of allergen-specific IgG4 antibodies, which act as blocking antibodies to prevent allergen binding to IgE on mast cells (MCs) and basophils. However, IgG4 responses are sometimes ineffective due to variations in antibody affinity and epitope targeting. Reverse class switching from IgE to IgG4 and selective depletion of IgE-producing B cells represent potential strategies to improve AIT efficacy. Tregs play a central role in AIT by suppressing Th2-driven allergic responses and promoting immune tolerance through anti-inflammatory cytokines interleukin (IL)-10 and transforming growth factor (TGF)-β. However, genetic and environmental factors may impair Treg function, leading to AIT failure. AIT reduces MC and basophil activation, leading to long-term suppression of allergic inflammation. It modulates IgE-FcεRI interactions and cytokine signaling pathways, but in some cases, anaphylactic reactions or resistance to MC desensitization may occur. Discussion and conclusions: While AIT is a highly effective allergy treatment, variability in immune responses can impact its success. Advances in biologic therapies offer potential synergies with AIT. Understanding these interactions will help refine AIT strategies and improve patient outcomes.
The purpose of this study is to examine the factors that influence vaccination options, including vaccination against COVID-19, in order to develop a management algorithm for decision-makers to reduce vaccination reluctance. This paper’s primary objective is to empirically determine the relationships between different variables that correlate to non-vaccination behavior of the target population, as well as the implications for public health and situational management strategies for future vaccination intentions. We created a questionnaire to investigate the personal approach to disease prevention measures in general and vaccination in particular. Using SmartPLS, load factors for developing an algorithm to manage vaccination reluctance were calculated. The results shows that the vaccination status of an individual is determined by their vaccine knowledge. The evaluation of the vaccine itself influences the choice not to vaccinate. There is a connection between external factors influencing the decision not to vaccinate and the clients’ motives. This plays a substantial part in the decision of individuals not to protect themselves by vaccination. External variables on the decision not to vaccinate correlate with agreement/disagreement on COVID-19 immunization, but there is no correlation between online activity and outside influences on vaccination refusal or on vaccine opinion in general.